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General NPI Number Information
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NPI Number | 1811049109
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Entity Type | Organization
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Legal Business Name | JOAN M YELANJIAN
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 625 MICHIGAN AVE
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City | SOUTH MILWAUKEE
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State | WI
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Zip | 53172-2724
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Country | US
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Telephone | 414-762-7297
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Fax |
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Provider Business Mailing Address
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Address Line | 625 MICHIGAN AVE
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City | SOUTH MILWAUKEE
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State | WI
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Zip | 53172-2724
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Country | US
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Telephone | 414-762-7297
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOAN MARIE YELANJIAN
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Credential | LCSW
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Telephone | 414-762-7297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2316123
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License Number State | WI
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